The 12-Step philosophy pioneered by Alcoholics Anonymous is used by about 74 percent of treatment centers. The basic premise of this model is that people can help one another achieve and maintain abstinence from substances of abuse, but that healing cannot come about unless people with addictions surrender to a higher power. The 12-Step movement can be a force for good for many people, but some struggle with what they interpret as a strong religious element of the program. Many addiction treatment programs offer alternatives to 12-Step methodology for those who prefer a more secular foundation for treatment.
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When alcohol dependence is mild or moderate, health practitioners commonly provide counselling or support to change behaviour. They may recommend particular strategies for avoiding situations which involve a high risk of excessive alcohol consumption (e.g. nightclubs) or coping with stressful situations without drinking alcohol. Health professionals can help identify sources of support, and suggest strategies that will help people dependent on alcohol regulate their own consumption (e.g. by having one or two alcohol-free days per week).
As defined by the American Society of Addiction Medicine (ASAM), addiction is a disease that disrupts brain chemistry and circuitry, which in turn impacts willpower, reward, memory, and motivation. The first step calls for individuals to accept that they are unable to control their drinking and/or drug use and that their willpower and motivation have been compromised. When someone struggles with addiction, they are no longer able to manage how much and how often drugs and/or alcohol are abused. Recognition of this loss of control and admission of being powerless over addiction is the first step toward recovery.
In some ways, the championing of anonymity has been AA’s blessing and curse. It not only protects the privacy of the people it seeks to help (and those who seek it for help), it also protects the organization at large from public relations and morale damage if a high-profile member were to relapse. In the more than 75 years since Alcoholics Anonymous formed, NPR notes that “no one knows how exactly it works.”
Gastrointestinal system. Alcohol causes loosening of the muscular ring that prevents the stomach's contents from re-entering the esophagus. Acid from the stomach flows backward into the esophagus(acid reflux), burning those tissues, and causing pain and bleeding. Inflammation of the stomach also can result in ulcers, bleeding, pain, and a decreased desire to eat. A major cause of severe, uncontrollable bleeding (hemorrhage) in an people with alcoholism is the development of enlarged (dilated) blood vessels within the esophagus, which are called esophageal varices. These varices develop in response to liver disease, and are extremely prone to bursting and hemorrhaging. Hemorrhaging varices are often fatal. Diarrhea is a common symptom, due to alcohol's effect on the pancreas. In addition, inflammation of the pancreas (pancreatitis) is a serious and painful problem in many people who abuse alcohol. Throughout the intestinal tract, alcohol interferes with the absorption of nutrients, which can result in a malnourished state. Alcohol is broken down (metabolized) in the liver and interferes with a number of important chemical reactions that occur in that organ. The liver begins to enlarge and fill with fat (fatty liver). Fibrous scar tissue interferes with the liver's normal structure and function (cirrhosis), and the liver may become inflamed (hepatitis).
At least two thirds of all alcohol consumed by Australians is consumed at levels which present either long or short term health risks. Some 10% of Australian men and women consume more than the average number of drinks recommended in the Australian guidelines. While a smaller proportion of Indigenous Australians drink than non-Indigenous Australians, a higher proportion of Indigenous Australians (20%) exceed the recommended average daily drinking limits than non-Indigenous Australians.
At the end of an intervention, the stage is set for entry into addiction treatment programs. There are many different options out there. Some facilities, for example, offer inpatient treatment for addiction. These programs allow people to step away from their day-to-day concerns and tackle an addiction around the clock, every single day. For some people, that tight focus is an ideal setup for healing. But outpatient centers can be ideal for those who want to stay at home, surrounded by family, while they work on addictions to alcohol. It’s a personal decision that families can make in consultation with the person who needs help.
Demographic preferences related to the addicts' drug of choice has led to the creation of Cocaine Anonymous, Crystal Meth Anonymous and Marijuana Anonymous. Behavioral issues such as compulsion for, and/or addiction to, gambling, crime, food, sex, hoarding, debting and work are addressed in fellowships such as Gamblers Anonymous, Overeaters Anonymous, Sexaholics Anonymous and Debtors Anonymous.